Inspection on 14/06/05 for Applegarth

This inspection was carried out on 14th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Applegarth 06/02/07

Applegarth 26/10/05

Applegarth 08/11/04

Applegarth 22/04/04

Similar services:

Hillside

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Chestnut Grange Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Applegarth 1 Rutland Close Leicester Forest East Leicester LE3 3PN Lead Inspector Bhavna Keane-Rao Unannounced 14 June 2005 at 9:30am th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Applegarth D C51 C01 S1826 Applegarth V225072 140605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Applegarth Address 1 Rutland Close Leicester Forest East Leicester LE3 3PN 0116 2395392 0116 2395392 None VISTA Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Gaynor Earle Care home 6 Category(ies) of LD Learning disability (6) registration, with number of places SI Sensory Impairment (6) Applegarth D C51 C01 S1826 Applegarth V225072 140605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 08/11/05 Brief Description of the Service: Applegarth is a smaller residential home providing care for up to 6 people. It is registered to provide care for people who need care because of visual impairment, who also have a learning disability. The emphasis is on homeliness, and there is no feel of an institutional setting, about the home.All rooms are single and en-suite, and are decorated to the wishes of the individual residents. They are situated on the ground floor, and there is a large lounge/dining room, kitchen and a conservatory on the same level. The garden is well tended and shows the different interests of the residents, with herbs, vegetables and flowers being grown. At present there is en extension being built which will provide all the bedrooms with an en-suite shower room and additional room space. Applegarth D C51 C01 S1826 Applegarth V225072 140605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place during Tuesday morning and early afternoon. A number of residents were spoken with, but detailed discussions were only held with one of them. A tour of the premises was undertaken and opportunity was taken to view residents daily records, menus of meals, fire records, a staff rota and staff records. The pre inspection questionnaire was also checked. The Applegarth is a small home, with philosophy of care that the residents are at the core of all care provided. What the service does well: What has improved since the last inspection? As per the home’s Fire Risk Assessment the fire alarms, fire drills and testing of the emergency lighting system is done so at the required frequency. Applegarth D C51 C01 S1826 Applegarth V225072 140605 Stage 4.doc Version 1.30 Page 6 Staff now follow VISTA policy on administration of medication and give out medication as prescribed by the doctor. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Applegarth D C51 C01 S1826 Applegarth V225072 140605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Applegarth D C51 C01 S1826 Applegarth V225072 140605 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3 and 4 The admission process is exceptionally well managed and residents entering the home are given all the information regarding the service. Residents and their relatives entering the home are always aware of their rights and the condition of their residency. All residents get an informed choice of this as their home. Resident entering the home are always assessed and so their needs are fully met. EVIDENCE: Examination of the Statement of Purpose indicated that the document accurately describes the services provided in the home. This is available on tapes and compact disc. The admission procedure is extensive in that assessments of individuals are carried out by health and/or social care professionals, as part of the referral process. There have not been any new referrals to the home. Two service user files viewed, detailed the specific care needs of service users, identifying the needs that would be met by heath and/or social care professionals. Applegarth D C51 C01 S1826 Applegarth V225072 140605 Stage 4.doc Version 1.30 Page 9 Applegarth D C51 C01 S1826 Applegarth V225072 140605 Stage 4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9 and 10 The provision of health care for residents who live at this home is totally met. Individual needs and choices are always given and met. The procedure to provide care for newly admitted residents is in place. EVIDENCE: Three residents were spoken with about the care they received at this home. Although detailed conversation was only held with one person, due to the extensive care needs of residents living at the home. Two individual care plans of residents were viewed. One resident spoken with stated that she was very involved in what happened to her in this home. She was able to choose the food she ate, what clothes she wore and what actives she participated in. This resident was also familiar with risk assessments and the reasons for these. Review records for the existing residents were found to contain minutes of meetings, reviews and action plans. The work undertaken by the staff to involve resident in all areas of care is exceptional and the registered manager and her staff are commended. Applegarth D C51 C01 S1826 Applegarth V225072 140605 Stage 4.doc Version 1.30 Page 11 Applegarth D C51 C01 S1826 Applegarth V225072 140605 Stage 4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15,16 and 17 Residents’ interests and hobbies are accommodated. Residents’ religious needs are met. Residents are encouraged to actively be involved in the local community. Residents are positively encouraged to maintain links with their friends and families. The meals provided residents are varied and balanced. EVIDENCE: One resident spoken with stated that she loved to go out and does something different everyday and that this was what she really enjoyed. She was particularly happy with the three certificate received for successfully completing College course, she is congratulated for this achievements. These Applegarth D C51 C01 S1826 Applegarth V225072 140605 Stage 4.doc Version 1.30 Page 13 courses were: Pathways to Progression, Making Music and Exploring Drama. The resident asked if this could be mentioned in this report. One resident does not wish to attend any structure day care provision. This person likes to do what he/she wants when he/she wants. The resident is very resistant to going out of the home, however the staff, over the last year, have encouraged him/her to go out of the home, then to the railway station to watch trains, then actually go on a train. This has been very gradual process and the staff are commended for their perseverance The Registered Manager and staff were seen to seek the permission of service users before entering bedrooms; a majority of residents hold a key to their bedroom. Residents wandered around the home freely, accessing communal areas, including leaving and returning to the home. Residents stated that they enjoyed the meals. Meals are cooked and prepared by staff; one resident stated she helps in the kitchen when she wishes too. One resident stated that they are encouraged to eat together in the dining room, however if they choose they can eat separately and at different times if they so choose. This was observed to be the case on the day of the visit. Applegarth D C51 C01 S1826 Applegarth V225072 140605 Stage 4.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 and 20 Residents and staff working together meet the physical and emotional needs of residents. In consultation with residents the staff manage their medication in a satisfactory manner. EVIDENCE: The records of three residents were viewed, records detailed visits made by and to health care professionals, which includes Community Psychiatric Nurses, Psychologists, Psychiatrists, Community Nurses, Social Workers, Dentists and Opticians. At present residents are not able to manage their own medication, however risk assessments have been carried out to ensure that resident’s rights are not compromised. The medication administration, recording and safe handling of medication is satisfactory. Applegarth D C51 C01 S1826 Applegarth V225072 140605 Stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 Residents are confident in discussing any issues of concerns with the staff or the manager before it leads to a complaint. Residents are protected from abuse, neglect and self harm. EVIDENCE: Applegarth has a formal Complaints procedure, which the resident who was spoken with was aware of. There have not been any complaints received by the home or the Commission for Social Care Inspection since the last inspection. One resident who was spoken with in detail stated that every time she raised any issues of concerns these were acted upon. Staff at the home were able to clearly demonstrate their awareness of the home’s Vulnerable Adults Procedure and Whistle blowing procedures. A member of staff was spoken with in detail and was able to clearly demonstrate the need for these procedures. The induction procedure was also discussed. This includes protection of vulnerable adults. Applegarth D C51 C01 S1826 Applegarth V225072 140605 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,29 and 30 There have been improvements to the décor of the home since the last inspection. All areas are clean, well kept and individualised. EVIDENCE: The home, a bungalow, is well maintained and suited to residents needs. There is ample natural light throughout the home. It is decorated and furnished to a high standard that creates a comfortable homely atmosphere. There is a lounge/dining leading to the kitchen. Entry to the home and to the garden is wheelchair friendly. The garden area is flat with climbing plants, pot plants and seating. There are handrails throughout the home. Staff are trained to use specialist equipment available the home to maximise residents independence. Several residents bedrooms viewed were homely with ample space. Residents are able to bring items of furniture and personal possessions with them. Every single bedroom is totally individualised reflecting the interests and hobbies of the residents. Applegarth D C51 C01 S1826 Applegarth V225072 140605 Stage 4.doc Version 1.30 Page 17 All areas of the home were cleaned to a high standard with pleasant smells. There are plans to extend the home so that all the bedrooms have more space with full shower en-suite. Applegarth D C51 C01 S1826 Applegarth V225072 140605 Stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34,35 and 36 The staff at the home are competent and able to provide for the care needs of residents at the home. There is ongoing training to ensure that all the staff are providing high quality care. The staff members ensure that they meet the care needs of residents. EVIDENCE: Since the last inspection two members of staff have left the home, the reason their resignations have been career progression. The staff within the home, including the manager, have worked additional hours to cover this shortfall as a short term measure. However new staff have been recruited now, although the manager is still recruiting to ensure that the high standard of care is provided. There are always at least three staff and a senior person on duty to provide care for the six residents. The responsibilities of the staff in the home, in addition to care, include cleaning, preparation and cooking of meals, the laundry and any other tasks as identified by the manager. The residents that were spoken with were positive about the staff employed at the home. One particular resident stated that he was always encouraged to go Applegarth D C51 C01 S1826 Applegarth V225072 140605 Stage 4.doc Version 1.30 Page 19 out to the day centre and also to try to be more independent. The observed interaction between the staff and residents was relaxed and friendly. Three staff files of staff were viewed, all were found to contain a completed application form, two satisfactory written references, and all three contained a declaration that a satisfactory Criminal Record Bureau check had been received. Applegarth D C51 C01 S1826 Applegarth V225072 140605 Stage 4.doc Version 1.30 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38,39,40 and 42 The Registered Manager offers a clear sense of leadership, which has developed during the years she has managed the home, which reflects on the day-to-day delivery of care of residents and running of the home. The outcomes are extremely positive. The health, safety and welfare of residents are promoted and protected. EVIDENCE: The staff members spoken with stated that they felt very supported by the registered manager and that there were systems in place to ensure that their concerns were addressed. Discussion with a new member of staff demonstrated that this. There are regular staff meetings, staff supervisions and residents meeting which enable the manager to ensure that the provision of care is based upon her own philosophy of care. Applegarth D C51 C01 S1826 Applegarth V225072 140605 Stage 4.doc Version 1.30 Page 21 The resident who was spoken with was very positive about the way in which her right are protected and safeguarded. She stated, “ I feel very relaxed and safe at home (Applegarth)”. The registered manager was able to clearly demonstrated that the ultimate aim for this home is to make sure that residents are encouraged to fulfil their goals in a clear and supported way. This was further substantiated by the staff who were spoken with. Applegarth D C51 C01 S1826 Applegarth V225072 140605 Stage 4.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 x Standard No 22 23 ENVIRONMENT Score 3 4 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 4 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 x 4 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x x 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Applegarth Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x 3 3 3 x 4 x D C51 C01 S1826 Applegarth V225072 140605 Stage 4.doc Version 1.30 Page 23 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Applegarth D C51 C01 S1826 Applegarth V225072 140605 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection The Pavilions 5 Smith Way Grove Park, Enderby Leicester, LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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